Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | D1095 | NJ |
NPI | 1003976663 |
---|---|
Provider Name | Mr. Dominick B Piantoni |
First Address | Mercerville, NJ 08619-4110 |
Second Address | Mercerville, NJ 08619-4110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 17/03/2009 |